Jabłecki Jerzy, Pielka Stanisław
Instytut Pielegniarstwa, Państwowa Medyczna Wyzsza Zawodowa Szkoła w Opolu.
Neurol Neurochir Pol. 2004 Mar-Apr;38(2):137-42.
Nerve autograft has become recently the gold standard for the reconstruction of surgical nerve gap. Functional results of using this technique continue to improve with the advances in micro-neurosurgery and with greater understanding of neurobiology and nerve regeneration. Surgical reconstruction of extensive nerve injuries frequently exhausts the patient's own source of expandable autogenous nerve grafts. Nerve allografts would offer a limitless supply of graft material. The requirement of only transient immunosuppression to support the regeneration of host axons across the nerve allograft toward distal host receptors renders the nerve allograft an advantageous option for these otherwise irreparable nerve injuries. The methods of graft harvesting, preservation and patients' immunosuppressive regimen as well as the clinical outcomes following the nerve allotransplantation are discussed.
神经自体移植术近来已成为外科手术修复神经缺损的金标准。随着显微神经外科技术的进步以及对神经生物学和神经再生的深入理解,运用该技术的功能恢复效果持续改善。广泛神经损伤的外科重建常常耗尽患者自身可用于移植的自体神经来源。神经异体移植可提供无限的移植材料供应。仅需短暂免疫抑制以支持宿主轴突穿过神经异体移植向远端宿主受体再生,这使得神经异体移植成为治疗这些原本无法修复的神经损伤的一个有利选择。本文讨论了移植取材、保存方法、患者免疫抑制方案以及神经异体移植后的临床结果。